How Does Organ Donation Work After Death

The only way a deceased donor may be considered for organ donation is after he or she has been declared dead. The donor's family must authorize the donation. Organs may not be procured without the family's consent, even if the person is listed as a donor on his or her driver’s license.

Organ Donation After Brain Death vs. Cardiac Death

Most organ donors are people who suffer from head injuries that result in brain death. These head injuries may include a stroke, trauma after an accident or brain cancer that has not spread to other parts of the body.

Brain death occurs when blood and oxygen cannot flow to the brain, while the heart is still beating to provide blood and oxygen to other parts of the body. Patients with brain death usually require a ventilator or breathing machine to bring oxygen into the lungs.

In brain death, the organs remain functional and can be used for transplantation after a physician declares the patient dead. Because of the potential for conflict of interest, this physician may not be part of a transplant team.

Cardiac death is declared when the heart stops beating. Very few organ donations come from cardiac deaths. Lahey has chosen not to participate in cardiac death donations due to the uncertainty of their success rates, since organs begin deteriorating as soon as the heart stops delivering oxygenated blood to the body.

The Family’s Authorization

After a person has been declared brain dead, the local organ procurement organization (OPO) will ask the family for permission to harvest the organs of the deceased. Family members are the only ones who may give consent for donation, or refuse it. The OPO is legally not authorized to harvest organs without the family's consent.

How the Organ Recipient is Chosen

To prevent illegal or immoral activities, the United Network for Organ Sharing (UNOS) typically doesn’t allow the family of the deceased donor to choose who receives the organs. Instead, they are allocated to candidates on the UNOS waiting list, based on their medical characteristics.

There are rare instances when the family of the deceased donor may already have a friend or family member on the waiting list. In this case, if they are of compatible blood type, they may take part in “direct donation.” This means the needed organ is directed specifically to that person, regardless of their status on the waiting list. The remaining organs will still follow the standard allocation process.

How the Organs are Obtained

The OPO will wait for all donated organs (liver, kidneys, pancreas, etc.) to find recipients. They will then take responsibility to carefully harvest the organs, place each in a preservative solution, and transport them to their respective transplant centers.

Once the donated organs have been removed, the body of the deceased donor will be prepared for arrangements according to the family’s wishes. The donor will still be able to have an open-casket funeral, if so desired by the family.